File Format:

Microsoft Word - doc

Instructions
The "Request to Conduct DEQ Approved General Training Class" form (next page) is for instructors or for operators that want to get approved status for general training that is to be conducted in the future. This form is for renewal training or continuing education training that is not designed to provide the necessary training to pass a DEQ exam and does not have to be taught by a DEQ Approved Instructor. It is available, on the forms page under Operator Certification forms or on the Operator Certification page. This form must be completed and submitted to DEQ prior to a class being conducted to get DEQ training credit. All classes must provide at least 4 hours of classroom training time. The completed form may be mailed, faxed or e-mailed to me as indicated at the bottom of the form. The form is provided in 2 different formats for your convenience. The Microsoft Word format (.doc) may be submitted by mail or fax (if you print it out and complete it) or e-mail (if you save it as a file, complete it and then attach the file to an e-mail message). The Acrobat PDF format may be printed, completed and mailed or faxed.
To get training listed in the Main Event Newsletter it must be submitted by the date listed below for each of the three editions:
Training Submission Deadline Edition of the Newsletter
June 1st August
October 1st December
February 1st April
Each class must be submitted with an hourly agenda, a detailed syllabus, completed check list and a completed correct request form.
Checklist
 Hourly Agenda
 Class Syllabus
 Completed, correct request form
Date of Request: ____________________ Class #: __________________
Request to Conduct DEQ Approved General Training Class
1. Sponsoring Group: _______________________________________________________________
Operator
2. Person-In-Charge of Class: ________________________________________License #:____________¬¬¬__
Address: _______________________________________________________________
Phone # (Work/Home/FAX):___________________ / ___________________ / ____________________
E-mail Address: _______________________________________________________________
3. Instructor(s): _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
4. Class Location: _______________________________________________________________
Street Address: _______________________________________________________________
City: ____________________________State:________Zipcode:________________
5. Class Date(s): _______________________________________________________________
6. Class Meeting Hours: _______________________________________________________________
7. Training Hours Requested: _________
8. Is this class OPEN to anyone wishing to take the class? ____Yes ____No
9. Learning Objective(s): _______________________________________________________________
(continue on back if _______________________________________________________________
needed) _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
10. Other Information: _______________________________________________________________
_______________________________________________________________
11. Expected Attendance: ______ (for Attendance Record Forms)
12. Please attach agenda
13. Please attach syllabus.
ALL GENERAL TRAINING CLASS REQUEST FORMS MUST BE SUBMITTED 6 WEEKS PRIOR TO THE FIRST DAY OF THE CLASS.
IT IS THE RESPONSIBILITY OF THE INSTRUCTOR TO INSURE THAT ATTENDANCE RECORDS ARE CORRECTLY FILLED IN AND RETURNED TO DEQ WITHIN 10 WORKING DAYS OF THE LAST CLASS DAY.
Mail to: Oklahoma Dept. of Environmental Quality, Operator Certification, P.O. Box 1677, Oklahoma City, OK 73101-1677
or FAX to: 405-702-8101 or E-mail to: mark.kurklin@deq.ok.gov rev. 3/30/11
Class Agenda
For classes longer than two days, this page will need to be filled out and printed more than once.
_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
to
to
to
to
to
to
_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
to
to
to
to
to
to
to
[Enter course name - Syllabus]
Instructor [Type your name here]
Phone [Type your phone number here]
Office [Type your office location here]
E-mail [Type your e-mail address here]
Office Hours [Type your office hours here]
Text:
[Type required texts here.]
Description:
[Type a description of the course here.]
Goals:
[Type goal 1 of the course here.]
[Type goal 2 of the course here.]
[Type additional goals here.]
Requirements:
[Enter required activities and projects here.]
Resources:
[Enter special facilities, URLs, advisors here.]
Evaluation:
[Enter critieria for performance evaluation here.]

Click tabs to swap between content that is broken into logical sections.

Instructions
The "Request to Conduct DEQ Approved General Training Class" form (next page) is for instructors or for operators that want to get approved status for general training that is to be conducted in the future. This form is for renewal training or continuing education training that is not designed to provide the necessary training to pass a DEQ exam and does not have to be taught by a DEQ Approved Instructor. It is available, on the forms page under Operator Certification forms or on the Operator Certification page. This form must be completed and submitted to DEQ prior to a class being conducted to get DEQ training credit. All classes must provide at least 4 hours of classroom training time. The completed form may be mailed, faxed or e-mailed to me as indicated at the bottom of the form. The form is provided in 2 different formats for your convenience. The Microsoft Word format (.doc) may be submitted by mail or fax (if you print it out and complete it) or e-mail (if you save it as a file, complete it and then attach the file to an e-mail message). The Acrobat PDF format may be printed, completed and mailed or faxed.
To get training listed in the Main Event Newsletter it must be submitted by the date listed below for each of the three editions:
Training Submission Deadline Edition of the Newsletter
June 1st August
October 1st December
February 1st April
Each class must be submitted with an hourly agenda, a detailed syllabus, completed check list and a completed correct request form.
Checklist
 Hourly Agenda
 Class Syllabus
 Completed, correct request form
Date of Request: ____________________ Class #: __________________
Request to Conduct DEQ Approved General Training Class
1. Sponsoring Group: _______________________________________________________________
Operator
2. Person-In-Charge of Class: ________________________________________License #:____________¬¬¬__
Address: _______________________________________________________________
Phone # (Work/Home/FAX):___________________ / ___________________ / ____________________
E-mail Address: _______________________________________________________________
3. Instructor(s): _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
4. Class Location: _______________________________________________________________
Street Address: _______________________________________________________________
City: ____________________________State:________Zipcode:________________
5. Class Date(s): _______________________________________________________________
6. Class Meeting Hours: _______________________________________________________________
7. Training Hours Requested: _________
8. Is this class OPEN to anyone wishing to take the class? ____Yes ____No
9. Learning Objective(s): _______________________________________________________________
(continue on back if _______________________________________________________________
needed) _______________________________________________________________
_______________________________________________________________
_______________________________________________________________
10. Other Information: _______________________________________________________________
_______________________________________________________________
11. Expected Attendance: ______ (for Attendance Record Forms)
12. Please attach agenda
13. Please attach syllabus.
ALL GENERAL TRAINING CLASS REQUEST FORMS MUST BE SUBMITTED 6 WEEKS PRIOR TO THE FIRST DAY OF THE CLASS.
IT IS THE RESPONSIBILITY OF THE INSTRUCTOR TO INSURE THAT ATTENDANCE RECORDS ARE CORRECTLY FILLED IN AND RETURNED TO DEQ WITHIN 10 WORKING DAYS OF THE LAST CLASS DAY.
Mail to: Oklahoma Dept. of Environmental Quality, Operator Certification, P.O. Box 1677, Oklahoma City, OK 73101-1677
or FAX to: 405-702-8101 or E-mail to: mark.kurklin@deq.ok.gov rev. 3/30/11
Class Agenda
For classes longer than two days, this page will need to be filled out and printed more than once.
_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
to
to
to
to
to
to
_____________________________ ______________________________
Day of Class (Day of the Week) Date of Class (Month\Day\Year)
Time Period
(Example: 8:00 to 12:00) List topic for each time period below
to
to
to
to
to
to
to
[Enter course name - Syllabus]
Instructor [Type your name here]
Phone [Type your phone number here]
Office [Type your office location here]
E-mail [Type your e-mail address here]
Office Hours [Type your office hours here]
Text:
[Type required texts here.]
Description:
[Type a description of the course here.]
Goals:
[Type goal 1 of the course here.]
[Type goal 2 of the course here.]
[Type additional goals here.]
Requirements:
[Enter required activities and projects here.]
Resources:
[Enter special facilities, URLs, advisors here.]
Evaluation:
[Enter critieria for performance evaluation here.]